Three-dimensional analysis of vascular changes after lymphangio-venular anastomosis by photoacoustic imaging

2020 Fiscal Year Final Research Report

• Project/Area Number: 19K18191
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55030:Cardiovascular surgery-related
• Research Institution: Keio University
• Principal Investigator: Kono Hikaru 慶應義塾大学, 医学部(信濃町), 助教 (00815897)
• Project Period (FY): 2019-04-01 – 2021-03-31
• Keywords: リンパ管吻合術

Outline of Final Research Achievements

Photoacoustic imaging was used to evaluate postoperative patency in lymphangio-venular anastomosis (LVA), a surgical treatment for lymphatic edema, and to evaluate changes in the lymphatic vessels and venous system. Focusing on the LVA, four patterns were observed: those in which both lymphatic vessels and veins could be identified, those in which either lymphatic vessels or veins appeared to have disappeared, and those in which both appeared to have disappeared. Of these, those that could be identified by both were thought to be findings indicating the patency of the anastomotic site. In some cases, it was possible to observe the dynamic lymphatic flow from the lymphatic vessels to the veins at the anastomotic site.

Free Research Field

形成外科学

Academic Significance and Societal Importance of the Research Achievements

従来の画像検査では、リンパ浮腫患者で頻繁に生じる画像所見「dermal backflow」によって皮下のリンパ管を観察できず、LVAの吻合部が開存しているかどうかを評価することは困難であった。光音響イメージングでは3次元的な画像が得られるため、dermal backflowに覆われた皮下の脈管の情報を得ることができ、LVAの吻合部も可視化できた。LVAの吻合部をリンパ管と静脈が接合する画像として可視化したのは世界で我々が初めてであり、本技術が広まることで、より正確なLVAの術後評価、ひいてはより優れたLVAの手技が普及することが期待される。